Provider Demographics
NPI:1922352186
Name:PRECIADO, RAQUEL C (LCSW)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:C
Last Name:PRECIADO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10964 CHOISSER ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2127
Mailing Address - Country:US
Mailing Address - Phone:323-896-6405
Mailing Address - Fax:
Practice Address - Street 1:10964 CHOISSER ST
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2127
Practice Address - Country:US
Practice Address - Phone:323-896-6405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS281351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical